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04-3995 (SFD)N Cs BUILDING & SAFETY DEPARTMENT (760) 777=7012 OF Tt�9 �r 5 C�TdMPICO t FAX (760) 777-7011 UINTA, CALIFORNI 253 INSPECTION REQUESTS 760 777-7153 - JUL 14 20�4 'BUI NG PERMIT , CITV OF l l4 ®UINIrA .. FINANf a ®EST. Application Number Z6 -_470_0-_00.3-9-9_5-_-X --- Date, 5 / 10 / 0 4 Property.Address . . . . . 80375 TORREON WY APNr 772-250-997-138 -31349-- Application description DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . . . LOW.DENSITY RESIDENTIAL Application valuation 227594 Owner Contractor, -.:.---------------------- --=----- - --------=------ TOLL CA V TOLL BROS, INC. C/O KEVIN D.DUERMIT 73121 FRED WARING DRIVE, #1.00 - 8901',E MOUNTAIN VIEW 200 PALM DESERT. CA 92260 SCOTTSDALE-. AZ 85258 WCC: ROGAL &.HAMILTO WC:: WA26D004723013, 09/01/04 CSLB: 77769;9 04/30/06 CCC: B. ----------------------- Structure Information -----------=------=------ Construction Type TYPE V - NON RATED Occupancy Type . . . . . .DWELLG/LODGING/CONG.<=10 Flood Zone . . . NON -AO FLOOD ZONE Other struct info CODE EDITION 2001 CBC # BEDROOMS 3.00 FIRE SPRINKLERS NO GARAGE SQ FTG.. 495.00 PATIO SQ FTG 399..00 ..NUMBER: OF UNITS 1.00 FIRST FLOOR SQ FTG 2'631.00 Permit . . . . . . BUILDING PERMIT Additional desc.. Permit Fee1087.50 Plan Check. Fee 176.;72 Issue Date . . . Valuation . 227594 Qty :Unit Charge Per Extension BASE FEE 1 639.50 128.00 3.5000 THOU BLDG 100,0'01-500,000 4'1 448.00 -------------------------------------------------------------------------------- Permit MECHANICAL , Additional. desc Perm'i't Fee 109.50 Plan Check Fee 6.85 Issue Date Valuation 0 Qty Unit Charge Per Extension ti. P.O. BOX 1504 • VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Applicant: Applicant's Mailing Address: - I G D� Date: ?- -0 Z/ Arch' ct or Engineer: Architect or Engineer's Address: ic. No.: _C-2 7 2,9 BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I here rn under penalty of perjury that I am licensed under glovisions of Chapter 9 (commencing with Section 7000) of Division 3 of the. Business and Professionals and my Liceis in full force and effect. / % cense Class _ License No41 V OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a, signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): U I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who -does the work himself or herself or through his or her own employees, provided that the improvements are.not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). U I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). U I am exempt under Sec. , BA P.C. for this reason Date Owner. WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 1 have and will maintain a certificate of consent to sed -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compe ion insurance,'as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' co pensabo ' surance caner and p lid num¢ r re: 'artier v Policy Number VIA 6 y/69O y Z2 3 O� I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so.as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with t se provisions. plaate icnt //O'� WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY hereby affirm under penalty of perjury that there is.a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name Lender's Address APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall, defend, indemnity and hold harmless the City of La Ouinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. 1 certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building con traction, and hereby authorize r presentatives of this county to enter upon the above-mentioned property for inspection purposes. Date d ignature (Applicant or Agent)df'"� �- 0 r - Application Number . . . . 04-00003995 Page ( .2 Date 5/10/04 ,Qty Unit Charge Per Extension BASE FEE 15:D0 2.00 9.0000 EA MECH FURNACE <=100K 18.D0 2.00 9.0000 EA MECH B/C <=3HP/100K BTU 18.D0 8.00 6.5000 EA MECH VENT FAN 52.D0 1.00 6.5000 EA MECH EXHAUST HOOD 6.30 Permit . . . . . . ELEC:--NEW RESIDENTIAL Additional desc Permit Fee . . . . 116.99 Plan Check Fee 7.31 Issue Date Valuation .0 Qty Unit Charge PerExtension BASE . FEE 15 . D 0 2631.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 52.D9 495.00 .0200 ELEC GARAGE OR.NON-RESIDENTIAL 9.)0 Permit . . . . . . PLUMBING Additional desc Permit Fee 189.00 Plan Check.Fee 11:31 Issue Date Valuation~�:•- :. 0 Qty Unit Charge Per Extension BASE FEE 15.D0 20.00 6..0000 EA PLB FIXTURE 120.D0 1..00 15.0000 EA PLB BUILDING SEWER 15:.D0 '1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.D0 1.00 9.0000 EA .PLB LAWN SPRINKLER SYSTEM 9.D0 6.00 7500 EA PLB GAS PIPE >=5 4.:) 1.00 15.0000 EA PLB '---------------------------------------------- GAS METER .15.D0 ------------------- Permit . . . ---------- . . . GRADING PERMIT Additional desc . Permit Fee 15.00 Plan Check Fee D0 Issue Date . . . . Valuation 0 Qty 'Unit Charge Per Extension BASE FEE .15.D0 Special Notes and Comments LOT 138. 2631 S.F. SFD. CAMINA Page 3 " Application Number, 04-000039.95 Date 5/10/04 Special Notes and Comments SB. PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL/SPA,. OR DRIVEWAY . APPROACH. 75% PLAN CHECK FEE REDUCTION APPLIED.FOR MULTIPLE ISSUANCE OF`SAME_ PLAN TYPE. Other. Fees . . . . . ART IN PUBLIC PLACES -RES 68.98 DIF'COMMUNITY CENTERS -RES 97.00 DIF•CIVIC CENTER - RES 366.00 ENERGY REVIEW: FEE 17.67 DIF FIRE,PROTECTION-,RES 97.00 GRADING PLAN CHECK FEE .00 DIF LIBRARIES - RES 225.00 DIF PARK MAINT FAC'- RES 5.00 DIF PARKS/REC - RES 502.00 STRONG MOTION (SMI)",- RES 22.75 DIF STREET MAINT FAC -RES 15.00 DIF.TRANSPORTATION - RES 1098.00 Fee summary Charged Paid .. Credited Due Permit Fee Total 1517.99 .0.0 .00 1517.99 Plan Check Total .2.02.69 .00 .00 202.69 Other Fee Total 2514.40 .00. .00. 2514.40 Grand Total 4235.08 .00 .00 4235.08 r